Radiofrequency ablation versus ethanol injection for early hepatocellular carcinoma: A randomized controlled trial

Brunello, F.; Veltri, Andrea; Carucci, P.; Pagano, Eva; Ciccone, Giovannino; Moretto, Paolo; Sacchetto, P.; Gandini, Giovanni; Rizzetto, Mario

doi:10.1080/00365520701885481

Cited by 262 publications

(247 citation statements)

References 31 publications

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“…However, follow up of these complications showed complete resolutions of ascites and pleural effusion suggesting that they were reactionary. This was in consistent with Brunello et al [24] who also stated that no major complications occurred among a total of 248 PEI sessions with average of 3.65 sessions per tumor. Follow up CT showed intraperitoneal hemorrhage in two patients but these resolved spontaneously.…”

Section: Discussionsupporting

confidence: 79%

Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

Helmy¹,

Abdel-Wahab²,

El-Shamy³

et al. 2016

Med-Science

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New therapeutic choices have been developed for hepatocellular carcinoma, including percutaneous ablation therapy, transarterial chemoembolization, radiation therapy and molecular target therapy. Ablation of liver tumors is currently the main alternative to liver resection. This work aimed at comparing percutaneous combined local injection of ethanol and mitoxantrone versus percutaneous radiofrequency ablation in the treatment of Hepatocellular Carcinoma. This study included 124 patients with hepatocellular carcinoma, they were randomly divided into two groups; group I (64 patients) treated with local injection of ethanol plus mitoxantrone. Group II (60 patients) treated with radiofrequency ablation. Clinical assessment, laboratory evaluation and CT studies were performed to all patients prior to treatment and at 1, 3, 6, and 12 months' post treatment. The percentage of ablation in both groups at 1, 3, 6 and 12 months were 81.3%, 81.3%,76.6 and 71.9% in group I respectively versus 88.3%, 88.3, 85%% and 81.7% in group II respectively with no statistical significant difference between the two groups. Percentage of ablation in small tumors is higher than large tumors in both groups. Side effects and complications are statistically higher in group II than group I. Combination of percutaneous local injection of ethanol and mitoxantrone is comparable to radiofrequency ablation with less frequent complications in the treatment of Hepatocellular Carcinoma when surgical resection or liver transplantation is not amenable or available.

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Section: Discussionsupporting

confidence: 79%

Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

Helmy¹,

Abdel-Wahab²,

El-Shamy³

et al. 2016

Med-Science

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“…RFA [Brunello et al 2008]. Both PEI and RFA carry a small risk of tumor seeding along the needle track.…”

Section: Locoregional Therapiesmentioning

confidence: 99%

Review: Current status of therapy for hepatocellular carcinoma

Corey

Pratt

2009

Therap Adv Gastroenterol

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The incidence of hepatocellular carcinoma (HCC) is increasing worldwide. A multidisciplinary approach is required for its management. Screening high-risk patients allows for earlier diagnosis and the use of potentially curative therapies. Current recommendations for HCC screening for patients with cirrhosis are an abdominal ultrasound and serum alpha fetoprotein level every 6 to 12 months. Treatment choice depends on tumor stage, liver function and the patient's overall functional status. Curative therapies include surgical resection, liver transplantation (LT), transarterial chemoembolization, and radiofrequency ablation (RFA). Surgical resection, either primary resection or LT, is the treatment most likely to result in cure of HCC. Which option to pursue is based on multiple factors. LT has the potential benefit of treating both HCC and the underlying cirrhosis; however, long wait times incur the risk of tumor progression. Firm recommendations regarding the role of living donor LT for HCC are not yet possible because of conflicting data. HCC recurrence after LT is 8-11% and several adjuvant therapies have been investigated to reduce this. Bridging therapy and tumor downsizing are techniques that also may be considered to deal with long waiting periods and qualification for LT, respectively. If neither LT nor primary resection is possible, locoregional therapies such as RFA and TACE should be considered. Systemic chemotherapies have proved disappointing for the treatment of HCC; however, newer targeted therapies such as sorafenib and cetuximab have provided new hope for the future.

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“…RFA is used more commonly and replaced PEI because of proven efficacy with regard to the survival and recurrence with few sessions of treatment. RFA induces coagulative necrosis of the tumor with safety margins around the lesion (16).…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary decision making in the management of hepatocellular carcinoma: A hospital-based study

Zaky

Makhlouf²,

Abdelmalek³

et al. 2015

Turk J Gastroenterol

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Background/Aims: To evaluate the short-term outcome of the decision taken by the Hepatoma Board for the treatment of Hepatocellular carcinoma (HCC). Materials and Methods: This was a prospective descriptive study involving 74 patients with HCC diagnosed by the known criteria. The decisions taken by the Hepatoma Board for the 74 patients were as follows: 1-surgical resection (7 patients), 2-local ablative therapy (LAT) (22 patients), 3-conventional transarterial chemoembolization (TACE) (24 patients), and 4-palliative supportive care (21 patients).Results: The short-term mortality rate was 25.7% of the total patients. The success rate was nearly equal in LAT (68.2%) and surgery (71.4%), whereas the success rate was approximately 33.3% in TACE. There was no difference in the mean total bilirubin level before and after LAT, surgery, or TACE (p>0.05 for each). There was a significant decrease in the mean serum albumin level after TACE (p=0.000). There was a decrease in the mean alpha fetoprotein level after surgery and LAT (p=0.033) for surgery and (p=0.048) for LAT. Conclusion: The management of HCC is better performed through a multidisciplinary team decision. Surgery has comparable outcome to LAT but is more invasive. According to our local experience, conventional TACE has a success rate of 33.3%.

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Radiofrequency ablation versus ethanol injection for early hepatocellular carcinoma: A randomized controlled trial

Abstract: The 1-year CR rate after percutaneous treatment of early HCC was significantly better with RFA than with PEI but did not provide a clear survival advantage in cirrhotic patients.

Cited by 262 publications

References 31 publications

Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

Review: Current status of therapy for hepatocellular carcinoma

Multidisciplinary decision making in the management of hepatocellular carcinoma: A hospital-based study

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